1980, 12-12 Permit: P80B-4832 Plumbing Fixtures'PLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE. WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
JOB ADDRESS ` g
BL/L/ A
Lor o (�fI t ug rolsl N
LEGAL DESCRIPTION — SEE ATTACHED
PARCEL NUMBER/S
OWN E)1\
3 ADDRESS
4.
.W` 44VInes Oreo 0
.-75217 kfr eWe
•NT•• TOR
,.✓�.LJ -red 1
dlid
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DESIGNER
5' ADDRESS
Pi foNE
O26 '.•y7 2V
ZIP
Actual Set Backs In Feet
North (South
Size of Parcel
PHONE
ZIP
East
'West
Zone Classification
Type Const. Occupancy
Valuation
Sprinklered
❑Vas 0No 0 Req'd.
Building Area in Sq. F1.
Main Floor
Upper Floors Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfm. Basement
TYPE
7. OF
WORK
$NEW 0,.,,(( ALT.
❑ BLD. T�LPLMB.
O AD N.
O MECH.
❑ RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
NO. Rooms
No..of Dwellings
I ESC$IBE WORK
s. JJ
3 Lqus ! rwb
VALUATION SOURCE
OF
9. UTILITIES
1 WJ!*cr T ifrtsl 7i
2 SA/Wks I k -3A. k
GAS
ELECTRIC
WATER
(
CERTIFICATE
of EXEMPTION
Enum. Dist.
ReCed.
Re 'd.
Not Heq'd.
Location (Area)
SEWER
Ownership
Peelle 0 Private I7
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of permit does not presume
to give authority to violate or cancel the provisions of any other state or local reg lating const/uction or the
performance of construction. S E REVERSE SIDE FOR REQUIRED INSPECT a S
DATE OF APPLICATION
SIGNATURE OF APPLICANT
SPECIAL APPROVALS SP CIAL CONDITIONS:
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA heckust
Ing Tec
L�
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
S'ngle $
Building
Plumbing .322_12:2
Mech.
Plan Check
SEPA
Mobile Home
u
Other 'eecclfy)
L.
TOTAL $ L_
7i,
PERMIT NUMBER
Ri -TVJj2
WHEN MACHINE VALIDATED IN THIS SPACE.
THIS BECOMES A PERMIT.
DAT ISSUEU2 —8 0
483.2=
PERMIT NO.
*35.000
0
0
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W